4603 1_2 Penkwe Way - Inspection Form
Residential Sanitary Sewer Service
Eity G r (ri Compliance inspection
Time Record Number J`
Date.~l PM
arn
1
Namel Disk# Time O Pm
rv
PID Number- -
House Number Street Name !A ~,°A-''
- r"
Alternative Mailing Address Prone
Ownerl0ccupapt'Signature Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
O No foundation drain connection O Clear- water connections to Unable to push past O No one in
t ? sanitary sewer feet
No roof drain connection O Access to service
f O Service lateral defects
O Sump pit not connected to lateral needed
O Defective manholes
sanitary sewer' O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer,
.r
No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number, of stacks # Entered S L at
Roots
Poor' Pipe joints -
Mineral Deposits
Sag/Pipe Deflection______
Damaged Pipe - } -
Transition 1, i _7 , <;r,r ..7.., „T i 'z•;
r`I)
1 /
! Y JV~f (1 '
4" to b" Transition: -Le4gfl+-ef SePvice;- Final Cleanout: -'r/ <; 7 r, a'
Notes
Number r f J~ JJ I p r f i
Total Correctly Incorrectly Unknown
pumps
Sump s
Foundation drains
Roof drains
White Copy. Property Owmer Yellow Copy- City of Eagan ¢ ` Pink Copy: SEH